Etiology Of Anxiety, Mood And Distruptive Behavior Disor

这是一项关于情绪在青春期精神病理学发展中的作用的生物行为纵向调查。重点是(A)负面情绪(愤怒、焦虑、悲伤)的多种成分在精神病理学演变中的作用，以及(B)导致情绪失调和紊乱的社会化经历和生物过程。情绪的失调体验和表达与外化(反社会模式)和内化(焦虑、抑郁情绪)障碍有关。青春期是这些疾病发展的关键时刻。在此期间，精神病理的发生率增加，临床问题在性别上变得更加分化，即男性更多的反社会行为，女性更多的焦虑和抑郁。我们研究了四组年轻人：(1)外在性和内在性问题共存，(2)外在性问题，(3)内在性问题，和(4)无症状。青少年的年龄从11岁到16岁不等，在两个时间点上学习，间隔两年。对同等数量的男性和女性进行研究，以检查症状、情绪调节和疾病表现方式的性别差异的病因学。使用了多方法、多受访者的方法。时间1包括生理和神经激素功能(ANS，HPA)，青年和家庭的行为观察，实验范式，结构化的心理访谈和问卷调查。时间2的结果基于访谈和问卷调查方法。两个时间点的数据收集刚刚完成，因此现在可以进行纵向分析，以确定精神和心理结果的预测因素。在时间1，神经荷尔蒙模式对男性和女性的精神症状的预测是不同的：例如，低睾酮水平只在男孩中与焦虑/抑郁有关，而颠覆性女孩表现出一天中产量的急剧下降。对脱氢表雄酮(DHEA)的分析也发现了重要的性别差异。结构方程模型估计了潜在焦虑抑郁和破坏性行为问题结构之间的关系，以及DHEA中的个体差异。女性的脱氢表雄酮水平高于男性，并与年龄和青春期发育呈正相关。DHEA水平从早上到中午下降了29%，从中午到下午晚些时候下降了6%。对于女孩来说，从中午到下午晚些时候，焦虑-抑郁水平越高，脱氢表雄酮水平就越高。脱氢表雄酮的反应性和社会挑战与焦虑抑郁和破坏性行为问题有关。就皮质醇水平而言，脱氢表雄酮水平的性别差异不同于先前的研究结果，即在皮质醇水平方面没有差异。这表明，DHEA或DHEA与皮质醇的比率可能比皮质醇水平本身更能反映焦虑和情绪障碍的神经激素基础上的潜在性别差异。在其他时间1的分析中，已经确定了青春期发育、神经心理功能、情感方式、应对和社会化方面的症状和差异之间的其他联系。现在的纵向分析将检查生物和环境因素，这些因素导致精神症状和心理问题随着时间的推移而增加、减少、转移和缺乏变化。当这些纵向分析完成后，它们将有助于阐明影响青少年男性和女性精神病理学表现形式的生物因素和社会化经历之间的相互作用。

This is a biobehavioral, longitudinal investigation of the role of emotion in the development of psychopathology in adolescence. The focus is on (a) the role of multiple components of negative emotions (anger, anxiety, sadness) in the evolution of psychopathology, and (b) socialization experiences and biological processes that contribute to emotion dysregulation and disorder. The dysregulated experience and expression of emotion is implicated in both externalizing (antisocial patterns) and internalizing (anxiety, depressed mood) disorders. Adolescence is a critical juncture in the development of these disorders. The incidence of psychopathology increases during this time period, and clinical problems become more differentiated along gender lines, i.e. more antisocial behavior in males and more anxiety and depression in females.Four groups of youths are studied: (1) comorbid externalizing and internalizing problems, (2) externalizing problems, (3) internalizing problems, and (4) asymptomatic. Youth range in age from 11 to 16 years and are studied at two time points, spaced two years apart. Equal numbers of males and females are studied in order to examine etiology of sex differences in symptoms, emotion regulation, and developmental changes in how disorders manifested. A multi-method, multi-respondent approach is used. Time 1 includes physiological and and neurohormonal functioning (ANS, HPA), behavioral observations of youth and family, experimental paradigms, structured psychatric interviews and questionnaires. Time 2 outcomes are based on interview and questionnaire methods. Data collection has just been completed for both time points so longitudinal analyses can now be conducted to determine predictors of psychiatric and psychological outcomes. At Time 1, neurohormonal patterns predict psychiatric symptoms differently for males and females: e.g. low testosterone levels are associated with anxiety/depression only in boys, while disruptive girls show a steep decline in production across the day. Analyses of DHEA (dehydroepiandrosterone) also identify important sex differences. Structural equation models estimated relationships between latent-anxiety-depression and disruptive behavior problem constructs and intra-individual differences in DHEA. DHEA levels were higher in females than males and were positively associated with age and pubertal development. DHEA levels decreased 29% from morning to mid-day and by 6% from mid-day to late afternoon. For girls, higher levels of anxiety-depression were associated with an increase in DHEA levels from mid-day to late-afernoon. DHEA reactivity tp social challenge was associated with anxiety-depression and disruptive behavior problems. The gender differences in DHEA levels differ from prevous findings of no differences for this sample in terms of their cortisol levels. This suggests that DHEA or the ratio of DHEA to cortisol may be more informative about potential sex differences in neurohormonal underpinnings of anxiety and mood disorders than will cortisol levels per se. In other Time 1 analyses, additional links between symptoms and differences in pubertal development, neuropsychological functioning, affective styles, coping and socialization have been identified. Longitudinal analyses now will examine biological and environmental factors that contribute to increases, decreases, shifts, and lack of change in psychiatric symptoms and psychological problems over time. When these longitudinal analyses are completed they will help to illuminate the interaction of biological factors and socialization experiences that influence the form of expression of psychopathology in adolescent males and females.